[Reconstruction of the superior vena cava by artificial graft bypass between right brachiocephalic vein and right atrial appendage preserving azygos vein circulation for mediastinal non-seminomatous germ cell tumor].

Itaru Ishida, Hiroyuki Oura, Hiromichi Niikawa, Masashi Handa, Masafumi Mitsui

Research output: Contribution to journalArticlepeer-review

Abstract

A 24-year-old man was admitted to our hospital for surgical resection of mediastinal non-seminomatous germ cell tumor after 4 courses of BEP therapy (cisplatin, bleomycin, etoposide). Although it became markedly smaller after chemotherapy, the tumor invaded the superior vena cava (SVC) and the left brachiocephalic vein (LBCV). Venogram demonstrated SVC obstruction above the azygos vein and missing LBCV. A blood return from the left upper limb was shown through thoracodorsal vein, intercostal vein, and accessory hemi-azygos continuation. Excision of residual tumor with SVC and LBCV was done through a median sternotomy. Vascular reconstruction was performed between the right brachiocephalic vein and the right atrial appendage with ringed polytetrafluoroethylene graft. SVC was sutured just above the azygos vein to preserve collateral circulation. LBCV reconstruction was abandoned because distal end of LBCV was entirely surrounded by postchemotherapy scar tissue. Venous occlusive symptoms were not seen in both intraoperative and postoperative period.

Original languageEnglish
Pages (from-to)463-467
Number of pages5
JournalKyobu geka. The Japanese journal of thoracic surgery
Volume64
Issue number6
Publication statusPublished - 2011 Jun 1
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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